T-cell lymphoblastic leukaemia: The Johannesburg state-sector experience
Background: T-cell lymphoblastic leukaemia (T-ALL) is a malignancy of immature T-cells which is reported to comprise 7% – 23% of cases of lymphoblastic leukaemia (ALL), making up a larger proportion of adult ALL than childhood cases. It is characterised by an increased risk for early relapse but rep...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
AOSIS
2022-06-01
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| Series: | South African Journal of Oncology |
| Subjects: | |
| Online Access: | https://sajo.org.za/index.php/sajo/article/view/229 |
| Summary: | Background: T-cell lymphoblastic leukaemia (T-ALL) is a malignancy of immature T-cells which is reported to comprise 7% – 23% of cases of lymphoblastic leukaemia (ALL), making up a larger proportion of adult ALL than childhood cases. It is characterised by an increased risk for early relapse but reportedly has superior outcomes as compared to B-cell ALL amongst adult patients. The frequency and clinical behaviour of T-ALL in Africa are unknown.
Aim: This study aimed to assess the prevalence and selected clinicopathological features of T-ALL in Johannesburg, South Africa (SA).
Setting: The Johannesburg state sector.
Methods: All cases of ALL diagnosed by flow cytometry in the state-sector hospitals of Johannesburg over 42 months between 2016 and 2019 were identified and pertinent data recorded from the laboratory information system.
Results: One hundred and eighty-one cases of ALL were identified, of which 59 (32.6%) were of T-cell lineage. The proportion of adult and paediatric ALL made up by T-ALL was similar (19/54 [35.2%] vs 40/127 [31.5%] respectively). Crude survival rates were very poor, with 80.0% having demised at the time of data collection. The mortality rate was overall significantly poorer amongst patients with T-ALL (80.0%) as compared to those with B-ALL (53.8%; p = 0.005) but was similarly poor in adults with B-ALL (83.3%) vs T-ALL (86.7%) (p = 0.53). The mortality rate did not differ between those with low-risk versus high-risk clinical features (77.8% vs 80.6%; p = 1.00).
Conclusion: T-cell lymphoblastic leukaemia makes up a larger proportion of ALL in Johannesburg than is reported elsewhere, and it is a high-risk disease that is not well stratified by conventional risk factors. |
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| ISSN: | 2518-8704 2523-0646 |